| NPI | 1215985783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 782-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11686) |
| 363A00000X Physician Assistant (Licence: WI 782-023) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-03-04 |